THE CHILD-LEARNER IN HEALTH EDUCATION

DEVELOPMENTAL CHARACTERISTICS OF LEARNERS

INFANCY TO TODDLERHOOD
Approximate Age:
Cognitive Stage:
Psychological Stage:

Birth to 3 years
Sensorimotor
Trust vs. Mistrust [birth to 1 year]
Autonomy vs. Shame & doubt [1 to 3 years]

General Characteristics
Dependent on environment.
Needs security.
Explores self and environment.
Natural curiosity.
Welcome active involvement.

Forge alliances.
Encourage physical closeness
Provide detailed information.
Answer questions & concerns.
Ask for information on childs strengths/
limitations & likes/dislikes.

Teaching Strategies
Orient teaching to care giver.
Use repetition & imitation of information.
- Stimulate all senses.
- Provide physical safety & emotional security.
- Allow play & manipulation of objects.
PRE-SCHOOLER
Approximate Age:
Cognitive Stage:
Psychological Stage:
General Characteristics:
Egocentric.
Thinking pre-causal, concrete & literal.
Believes illness is self-caused & punitive.
Limited sense of time.
Fears bodily injury.
Animistic thinking [objects possess
life /human characteristics].
Teaching Strategies
Use warm, calm approach.
Build trust.
Use repetition of information.
Allow manipulation of objects &
equipment.
Give care with explanation.
Reassure not to blame self.
Explain procedures simply & briefly.
Nursing Intervention
Welcome active involvement.
Forge alliances.
Encourage physical closeness.

SCHOOL AGE CHILDHOOD

3 to 6 years
Preoperational
Initiative vs. Guilt

Centration [focus is on 1 characteristic

of an object].
Separation anxiety.
Motivated by curiosity.
Acute imagination/prone to fears.
Play is his/her work.

Provide safe secure environment.

Use positive reinforcement.
Encourage questions to reveal
perceptions/feelings.
Use simple drawings & stories.
Use play therapy with dolls & puppets.
Stimulate senses: visual auditory,
tactile, motor.
Provide detailed information.
Answer questions & concerns.
Ask for information on childs strengths/
limitations & likes/dislike

Approximate Age:
Cognitive Stage:
Psychological Stage:
General Characteristics
More realistic & objective.
Understand cause & effect.
Deductive/inductive reasoning.
Wants concrete information.
Able to compare objects & events.

6 to 12 years
Concrete operations
Industry vs. Inferiority

.
Teaching Strategies
Encourage independence & active
participation.
Be honest, allay fears.
Use logical explanation.
Allow time to ask questions.
Use analogies to make invisible process
real.
, models, dolls, paintings, audio & video tapes.
Nursing Intervention
Welcome active involvement.
Forge alliances.
Encourage physical closeness.

Variable rates of physical growth.

Reasons syllogistically.
Understands seriousness &
consequences of actions.
Subject-centered focus immediate
orientation

Establish role models.

Relate care to other childrens
experiences; compare procedures.
Use subject centered focus.
Use play therapy.
Provide group activities.
Use drawings

Provide detailed information.

Answer questions & concerns.
Ask for info on childs strengths/
limitations & like/dislikes.

ADOLESCENCE
Approximate Age:
12 to 18 years
Cognitive Stage:
Formal Operations
Psychological Stage:
Identify vs. Role Confusion
General Characteristics:
Abstract hypothetical thinking.
Peer group is important.
Can build on past learning.
Intense personal pre-occupation,
Reasons by logic & understand scientific
appearance, extremely important
[imaginary audience].
principles.
Feels invulnerable, invincible, immune
Future orientation.
to natural law [personal fables]
Motivated by desire of social
acceptance.
Teaching Strategies
Establish trust, authenticity.
Focus on details.
Know their agenda.
Make information meaningful to life.
Address fears, concerns about outcome
Ensure confidentiality & privacy.
of illness.
Arrange group sessions.
Identify control focus.
Use audiovisuals, role play, contracts &
Include in plan of care.
reading materials.
Use peers for support & influence.
Provide for experimentation & flexibility.
Negotiate changes.
Nursing Intervention
Explore emotional & financial support.
Respect values & norms.
Determine goals & expectations.
Determine role responsibilities &
Assess stress levels.
relationships.

Allow for 1:1 teaching without parents

present, but with adolescents

permission, inform family of content

covered.

YOUNG ADULTHOOD
Approximate Age:
Cognitive Stage:
Psychological Stage:
General Characteristics
Autonomous
Self-directed
Uses personal experience to enhance/
interfere with learning.
Teaching Strategies
Use problem-centered focus.
Draw on meaningful experiences.
Focus on immediacy of application.
Encourage active participation.

18-40 years
Formal Operations
Intimacy vs. Isolation

Intrinsic motivation.
Able to analyse critically.
Make decisions about personal,
occupation & social roles.

Allow to set own pace, be self-directed.

Organize material.
Recognize social role.
Apply new knowledge through role
playing & hands-on practice.

Nursing Interventions
Explore emotional, financial & physical support system.
Assess motivational level for involvement.
Identify potential obstacles & stressors.

MIDDLE ADULTHOOD
Approximate Age:
40 to 65 years
Cognitive Stage:
Formal Operations
Psychological Stage:
Generativity vs. Self absorption & Stagnation
General Characteristics
Sense of self is well developed.
Yellowing of lenses, distorts low tone
Concerned with physical changes.
colors; blue, green, violet.
Distorted depth perception.
At peak in career.
Fatigued/decreased energy levels.
Explore alternative life styles.
Pathophysiology [chronic illness]
Reflects on contributions to family &
Psychosocial changes.
society.
Re-examines goals & values.
Decreased risk taking.
Questions achievements & successes.
Selective learning.
Has confidence in abilities.
Intimidated by formal learning.
Desires to modify unsatisfactory aspects
of life.
Teaching Strategies
Focus on maintaining independence & re Ensure accessibility & fit of prosthesis
establishing normal life patterns.
[i.e. glasses, hearing aid]
Assess positive & negative past
Keep sessions short.
experiences with learning.
Provide for frequent rest periods.
Assess potential sources of stress due to
Allow for extra time to perform.
middle crisis issues.
Establish realistic short term goals.
Provide information to coincide with life
Give time to reminisce.
concerns & problems.
Identify & present pertinent material.
Use informal teaching sessions.
Nursing Intervention
Explore emotional, financial & physical support system.

Assess motivational level for involvement.

Identify potential obstacles & stressors.

LATE ADULTHOOD
Approximate Age:
Cognitive Stage:
Psychological Stage:
General Characteristics
Cognitive changes.
Decreased ability to thick abstractly;
process information.
Decreased short term memory
Increased reaction time & anxiety.
Stimulus persistence [after image].

Visual changes
Farsighted [needs glasses to read].
Lenses become opaque [glare problems]
Smaller pupil size [decreased visual
adaptation to darkness].
Decreased peripheral perception.
Yellowing of lenses,[distorts low tone
colors; blue, green, violet].
Teaching Strategies
Use concrete examples.
Build on past life experiences.
Make information relevant & meaningful.
Present one concept at a time.
Allow time for processing/response [slow
pace].
Use repetition & reinforcement of
information.
Avoid written exams.
Use verbal exchange & coaching.
Establish retrieval plan [use 1 or several
clues]
Encourage active involvement.
Keep explanations brief.
Use analogies to illustrate abstract
information.
Speak slowly, distinctly.
Use low pitched tones.
Pace client when speaking.
Minimize distractions.
Avoid shouting.
Use visual aids to supplement verbal
instruction.
Avoid glares, use soft white light.
Nursing Interventions
Involve principal care givers.
Encourage participation.

5 years and above

Formal Operations
Ego integrity vs. Despair
Focuses on past life experiences.
Sensory/motor deficits & auditory
changes.
Hearing loss, especially high pitched
tones consonant [s,z,t, f, & g] & rapid
speech

Distorted depth perception.

Fatigued/decreased energy levels.
Pathophysiology [chronic illness]
Psychosocial changes.
Decreased risk taking.
Selective learning.
Intimidated by formal learning.
Provide sufficient light.
Use white backgrounds & black prints.
Use large letters & well-spaced print.
Avoid color coding with blues, greens,
purples & yellows.
Increase safety precautions/provide safe
environment.
Ensure accessibility & fit of prostheses
[i.e. glasses].
Keep sessions short.
Provide for frequent test periods.
Allow for extra time to perform.
Establish realistic short term goals.
Give time to reminisce.
Identify & present pertinent material.
Use informal teaching sessions.
Demonstrate relevance of information to
daily life.
Assess resources.
Make learning positive.
Identify post positive experiences.
Integrate new behaviours with formerly
established ones.

Provide resources to support respite care.

Assess coping mechanism.
Provide written instruction reinforcement.
Provide anticipatory problem solving [what happens if].

CHARACTERISTICS ACCORDING
TO GROUP
FAMILY
Is the smallest institution with the unique function of producing and rearing the young.
It is composed of interacting persons united by blood, marriage or adoption, constituting a
household, carrying a common culture and performing basic functions.
Types of Families according to Structure:
Conjugal / Nuclear family consists of husband, wife & children
Consanguine / Extended consists of married couple, siblings, grandparents, uncles, aunts and
cousins. They may live in one house or not.
Classification according to Line of
Reproduction of the race and rearing of
Descent:
the young.
Patrilineal
Cultural transmission or enculturation.
Matrilineal
Socialization of the child. role & status
Bilineal
Providing affection & a sense of security.
Classification according to Residence:
Provide the environment for personality
Patrilocal
development & the growth of self concept
in relation to others.
Matrilocal
SCHOOL & COMMUNITY
Neolocal
The school is an institution
Functions of the Family
established by society for the basic
enculturation of the young.
Functions of the School:
Instructional
The community & its effect on the school.
Enculturation the young internalise the
Proposes that the community should
help the school.
culture of their time & place, build the
The community as resource for the
social aspects of their personality &
become acceptable persons in society.
school.
Responsible for socialization helping
SOCIETY & NATION
pupils find their roles & status in society
Industrialization the rise in the
& learn the forms of behaviour that go
social scale followed attainment of
with the roles and status.
a level of technological
Acculturation wherein pupils learn
development.
about other countries & peoples, their
Urbanization
ways of life, customs, traditions &
Size
products.
Occupation
Teachers act in loco parentis since the
Economic status
school is their second home.
Education
The school & the Community
Age groups
The school in the community. Makes
Improved Transportation
the school part of the community & must
Mobility of Population
be of service to it.
Working Mothers
Compadre System